Using the European Health Insurance Card (EHIC) in Spain

Key points for Spanish residents and expatriates:

The European Health Insurance Card is for short term visitors to Spain, and those temporarily living or working or studying in Spain.

It is not intended for use by permanent residents.

It only covers state medical care; if you go to a private doctor or clinic, you will not be able to use your card.

The EHIC card only entitles you to essential medical treatment. If you are temporarily or permanenently living or working in Spain, you should seriously consider buying International or Expatriate Health Insurance.

If you are thinking of going to Spain for the purpose of medical treatment (medical tourism), the European Health Insurance Card will not cover you if you have gone there for the express purpose of obtaining medical treatment.

The card in detail

The European Health Insurance Card (EHIC) replaced the E111 form in January 2006 and many people think that if they flash this piece of plastic they will be covered for all their healthcare needs while in another EU country, and consequently they do not bother taking out any other medical or travel insurance. The fact is that the EHIC is NOT a substitute to medical or travel insurance. It entitles the visitor to emergency medical treatment in Spain on the same terms as the locals but medical repatriation, on-going medical treatment or treatment of a non-urgent nature is not included.

In brief, the EHIC entitles a person to reduced-cost (sometimes free), medical treatment that becomes necessary while in a European Economic Area (EEA) country (or Switzerland). The EEA consists of the European Union (EU) countries, which includes Spain. People who are ordinarily resident in the UK are entitled to a UK-issued EHIC and this is normally valid for three to five years. It covers any medical treatment that becomes necessary during a trip due to illness or accident, giving access to state-provided medical treatment only, on the same basis as an 'insured' person living in Spain.

Be aware that it might not cover the things you would expect to get on the NHS in the UK which means that an additional contribution may be needed. Having shown your European Health Card (EHC), you will be seen by a GP at a local health centre or in your home if you cannot make it to the centre. If you need to see a specialist or go into hospital, the GP will give you the relevant medical certificate or referral.

What it does not cover

Although the EHIC will cover you for emergency healthcare treatment, the EHIC won't cover you for most types of non-urgent treatment for ongoing conditions, maternity care, or vaccinations and it definitely won't cover you if getting medical treatment is the main purpose of your trip. Consequently, whether you are living or just visiting the country, private medical insurance or travel insurance is advised.

Remember, the EHIC is for tourists. Although it means that you do not have to pay for treatment during your first few weeks or months in Spain it should NOT be relied upon as a healthcare provision for residents in Spain, but rather an essential item to have until you get your Social Security Card (SSC), or organise Spanish private health insurance or expatriate health insurance.

What if I don't have a card?

If you come to Spain without the card, you will of course receive the treatment necessary, but may have to pay up front. A Spanish doctor cannot refuse to treat you if your state of health necessitates treatment. The doctor or Spanish hospital or clinic might well ask you to pay the full cost, or to pay up front a proportion of the costs.

Enquire about treatment and costs

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